In comparison with sucrose intake, peak glucose concentrations were significantly 2.5 mmol/L (20%) lower with Palatinose ingestion (P < 0.01) (Fig. 1A).Accordingly, insulin secretion was 55% lower after Palatinose ingestion compared with sucrose intake (Fig. 1B). We observed an initial small increase in glucagon concentrations during the first 15 min and followed by a sharp reduction until 180 min. There were no significant differences in plasma glucagon levels between sucrose and Palatinose loading (Fig. 1C).

Following sucrose intake, plasma concentrations of GIP peaked at 15 min with 2.8-fold increase (P < 0.001). Responses of GIP to Palatinose were dramatically smaller and delayed peaking after 60 min with 1.5-fold increase (P < 0.001) (Fig. 1D). Consequently, the incremental area under the curve (iAUC), which was calculated by trapezoid rule, of GIP was substantially reduced by 40% (P < 0.001) following Palatinose intake compared with sucrose intake (Fig. 1E).

After sucrose intake, GLP-1 concentrations briefly increased to a maximum and then rapidly declined to nearly baseline values within 60 min postload. Conversely, GLP-1 concentrations after Palatinose ingestion decreased slightly but remained significantly higher than sucrose. Accordingly, GLP-1iAUC was remarkably and significantly 6.3-fold (P < 0.05) higher after Palatinose administration in comparison to that following sucrose administration (Fig. 1F and G).

We show the beneficial effects of Palatinose on glucose metabolism and reduced insulin secretion without influence on glucagon levels in T2D subjects. Both disaccharides elicited almost opposing profiles of GIP and GLP-1, which is well explained by the slow cleavage of the 1,6-disaccharide bond in Palatinose as compared with the 1,2-disaccharide bond in sucrose by intestinal glucosidases (5). Therefore, Palatinose bypasses the upper intestinal K cells producing GIP and reaches the more distally located L cells producing GLP-1. As glucose and fructose are known to be completely resorbed, the differences in intestinal hormone responses must explain the much more favorable metabolic profile after Palatinose intake. Thus, Palatinose possesses a favorable profile for diabetes nutrition by lowering postprandial endogenous GIP levels, increasing GLP-1 concentrations, and saving insulin secretion, which ultimately results in better management of blood glucose in T2D.

Article Information

Acknowledgments. The authors thank the staff of the Clinical Research Unit at the German Institute of Human Nutrition Potsdam-Rehbrücke and the patients for their contribution. The authors are grateful to Katrin Sprengel, from German Institute of Human Nutrition, for her excellent technical assistance.

Funding. This work was funded by grants awarded by the Federal Ministry of Education and Research of Germany (BMBF grant no. 0315669) and the German Research Foundation (DFG Pf 164/14-2).

Author Contributions. F.K.-N. contributed to the data collection, statistical analysis, data interpretation, and drafting of the manuscript. M.K. contributed to the study design, subject recruitment, data collection, and drafting of the manuscript. R.S. researched the data and reviewed and edited the manuscript. O.P. contributed to the data interpretation and discussion and reviewed and edited the manuscript. N.R. contributed to the data interpretation and critical review of the manuscript. A.F.H.P. contributed to the study conceptualization and design, data interpretation, and critical review of the manuscript. A.F.H.P. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.